The document discusses various topics related to anaesthesia including:
- Types of anaesthesia such as general, local and balanced anaesthesia.
- Preanaesthetic medications that are used to relieve anxiety and prevent complications.
- Stages of anaesthesia from analgesia to medullary paralysis.
- Molecular targets of general anaesthetics such as GABA-A and NMDA receptors.
- Classification of anaesthetics into inhalational and intravenous agents.
- Properties, uses and side effects of common inhalational agents like halothane, sevoflurane and nitrous oxide.
- Intravenous induction agents including thiopentone, propofol and ketamine.
This document discusses tuberculosis (TB) drugs and adverse drug reactions (ADRs). It begins by differentiating between primary TB disease and post-primary (reactivated) TB. It then describes the typical presentations, locations, and diagnostic findings of primary TB disease. It also discusses the aims of TB treatment, essential TB drugs, standard treatment protocols, adjunctive treatments including steroids, common side effects of TB drugs, and medicine-induced hepatotoxicity. Management of hepatotoxicity involves stopping all medications, monitoring symptoms and liver function tests, and cautiously reintroducing drugs once liver function improves.
tuberculosis ram. nepal civil service hospRAMJIBANYADAV2
Tuberculosis is an infectious disease caused mainly by Mycobacterium tuberculosis that typically affects the lungs. It can be spread through droplets from the throat and lungs of people with the active respiratory disease. Tuberculosis can also affect other parts of the body in its extra pulmonary form. Diagnosis involves microscopic examination of sputum samples, culture tests and radiography. Treatment requires a multi-drug regimen over a period of 6-9 months. Preventive measures include BCG vaccination, isolation of active cases, and directly observed treatment.
Here are the key types of fever patterns:
a) Continuous fever - Fever persists continuously without significant variation in temperature. Seen in conditions like tuberculosis, bacterial endocarditis.
b) Intermittent fever - Fever with abrupt onset and remission, such as in malaria. Temperature spikes occur at regular intervals.
c) Remittent fever - Fever that decreases but does not return to normal. The temperature remains elevated between peaks, such as in typhoid fever.
This document discusses fever of unknown origin (FUO). It categorizes FUO into classical, nosocomial, neutropenic, and HIV-associated types. The most common etiologies of FUO are infections (30-60%), collagen vascular diseases (20-35%), and malignancies (10-20%). The diagnostic approach involves a careful history, physical exam, and diagnostic testing including blood tests, imaging, and biopsy. Empirical therapeutic drug trials may be used for suspected conditions like tuberculosis or culture-negative endocarditis, but have limitations and risks. The goal is to reach a specific diagnosis to guide appropriate treatment.
1663503021.ppt ram jiban Yadav heath b dsaRAMJIBANYADAV2
1. The aims of the lecture are to define pyrexia of unknown origin (PUO), discuss the causes of fever, and approach to diagnosing PUO.
2. Common causes of PUO include infections (30% of cases), malignancies (20%), and connective tissue disorders (15%). Infections may be specific to locations, organisms, or patient groups.
3. Diagnosing PUO involves taking a thorough history, physical exam, and running microbiological, imaging, and immunological tests to identify potential infectious, inflammatory, or malignant causes. A multidisciplinary approach is often needed.
Hypocalcemia can be caused by a variety of factors that result in decreased calcium levels in the blood. The most common causes are hypoparathyroidism, vitamin D deficiency, and magnesium depletion. Clinically, hypocalcemia presents with paraesthesia around the mouth and extremities, muscle cramps, carpopedal spasms, tetany, seizures, and cardiac abnormalities like prolonged QT interval on ECG. Treatment involves calcium supplementation, often with vitamin D, to replace the deficient levels and address the underlying cause.
According to a study in Nepal, the most common causes of pancytopenia (low levels of all blood cell types) are hypoplastic bone marrow, hematological malignancies like leukemia, and megaloblastic anemia. The document then describes a 45-year-old man who noticed red-colored urine on two occasions and sought medical attention due to concern over the recurring symptom.
Hypocalcemia can be caused by several factors like vitamin D deficiency, malabsorption, renal losses, drugs like platinum agents, and conditions affecting the parathyroid glands. Clinical manifestations include paraesthesia, muscle cramps, seizures, and cardiac arrhythmias due to increased neuromuscular irritability when calcium levels drop. Diagnosis involves measuring serum and ionized calcium levels along with phosphate and parathyroid hormone levels. Treatment focuses on replacing calcium supplementation and treating the underlying cause.
This document defines fever of unknown origin (FUO) as a fever over 38.3°C on at least two occasions lasting over 3 weeks where the cause remains uncertain after examinations. It also defines inflammation of unknown origin (IUO) as similar but without fever. The most common causes of FUO are listed as infections (40%), neoplasms (20%), non-infectious inflammatory diseases (20%), miscellaneous causes (10%), and undiagnosed (10%). In non-Western countries, infections like tuberculosis account for 50% of cases, while in Western countries non-infectious inflammatory diseases are more common.
DR.RAM%20PPT.pptxcivil service Nepal kathMRAMJIBANYADAV2
A 45-year-old bank clerk experienced red urine on two occasions and sought medical attention. Tests were ordered to investigate the cause, including complete blood count, renal and liver function tests, electrolytes, LDH, calcium, uric acid, coagulation tests, and blood typing. Pancytopenia is a decrease in levels of all three major types of blood cells - red blood cells, white blood cells, and platelets. It can be caused by autoimmune destruction of blood stem cells in 40-50% of cases, as well as hepatitis, CMV, HHV, and other infections.
DENGUE FEVER BY DR.RADHE.pptx CIVIL HOSPITAL NEPALRAMJIBANYADAV2
Dengue fever is a mosquito-borne viral illness that has spread rapidly worldwide. It is transmitted by Aedes mosquitoes and causes flu-like symptoms including fever, headache, muscle pain and rash. There are four distinct serotypes of the dengue virus. Most cases resolve without complications, but severe dengue can occur, characterized by plasma leakage, bleeding or organ impairment. Treatment depends on severity of symptoms and involves oral rehydration or intravenous fluids and blood transfusions in severe cases.
Scrub typhus is caused by the bacteria Orientia tsutsugamushi, which is transmitted through the bites of infected chiggers (larval trombiculid mites). It causes non-specific symptoms like fever, headache, and rash. Diagnosis is made through serologic testing, PCR, or biopsy showing lymphohistiocytic vasculitis. Treatment involves doxycycline or azithromycin for mild-moderate cases. Severe cases are treated with doxycycline. Prevention focuses on avoiding chigger bites in endemic rural areas in parts of Asia and the Pacific.
This document provides an overview of various rheumatological conditions categorized by presenting symptoms such as fever with arthritis, Raynaud's phenomenon, oral ulcers, arthritis with neurological or pulmonary involvement, and ocular manifestations. For each symptom, it lists potential conditions and their associated diseases. It also outlines parts of the physical examination, diagnostic tests including blood tests, joint aspiration and synovial fluid analysis, imaging modalities, and potential drug histories, malignancy associations, and family histories that can aid in rheumatological diagnosis.
1. Therapy with DMARDs should begin immediately once a diagnosis of rheumatoid arthritis is made, with the goal of sustained remission or low disease activity.
2. Methotrexate should be the first treatment, and if it cannot be tolerated leflunomide or sulfasalazine can be considered.
3. Short term glucocorticoids can be used to bridge treatment until DMARDs take effect, but should be tapered off rapidly. Failure to sustain treatment targets after tapering glucocorticoids requires adjusting therapy.
This document provides guidance on evaluating joint pain through a step-wise process. It outlines taking a thorough history, physical examination, and lab investigations. The key steps include determining if the pain is articular or extra-articular, identifying if it is arthralgia or arthritis, distinguishing between inflammatory and non-inflammatory arthritis, assessing duration and pattern of joint involvement, and looking for extra-articular manifestations. Further guidance is given on specific physical exam assessments, potential lab tests, when to perform joint aspiration, and appropriate imaging studies. Common rheumatological conditions are highlighted throughout the evaluation process.
This document discusses systemic lupus erythematosus (SLE), a multisystem autoimmune disease. It covers the disease manifestations, assessment of disease activity, management approaches, and monitoring of treatment response. The goals of therapy are to achieve remission, prevent organ damage, minimize drug toxicity, and improve quality of life. Disease activity is assessed through patient history, examination, and laboratory tests. Treatment involves hydroxychloroquine for all patients along with additional therapies depending on disease severity and organ involvement. Specific treatments are outlined for various SLE manifestations. Newer targeted therapies and those under investigation are also mentioned.
The document discusses various topics related to anaesthesia including:
- Types of anaesthesia such as general, local and balanced anaesthesia.
- Preanaesthetic medications that are used to relieve anxiety and prevent complications.
- Stages of anaesthesia from analgesia to medullary paralysis.
- Molecular targets of general anaesthetics such as GABA-A and NMDA receptors.
- Classification of anaesthetics into inhalational and intravenous agents.
- Properties, uses and side effects of common inhalational agents like halothane, sevoflurane and nitrous oxide.
- Intravenous induction agents including thiopentone, propofol and ketamine.
This document discusses tuberculosis (TB) drugs and adverse drug reactions (ADRs). It begins by differentiating between primary TB disease and post-primary (reactivated) TB. It then describes the typical presentations, locations, and diagnostic findings of primary TB disease. It also discusses the aims of TB treatment, essential TB drugs, standard treatment protocols, adjunctive treatments including steroids, common side effects of TB drugs, and medicine-induced hepatotoxicity. Management of hepatotoxicity involves stopping all medications, monitoring symptoms and liver function tests, and cautiously reintroducing drugs once liver function improves.
tuberculosis ram. nepal civil service hospRAMJIBANYADAV2
Tuberculosis is an infectious disease caused mainly by Mycobacterium tuberculosis that typically affects the lungs. It can be spread through droplets from the throat and lungs of people with the active respiratory disease. Tuberculosis can also affect other parts of the body in its extra pulmonary form. Diagnosis involves microscopic examination of sputum samples, culture tests and radiography. Treatment requires a multi-drug regimen over a period of 6-9 months. Preventive measures include BCG vaccination, isolation of active cases, and directly observed treatment.
Here are the key types of fever patterns:
a) Continuous fever - Fever persists continuously without significant variation in temperature. Seen in conditions like tuberculosis, bacterial endocarditis.
b) Intermittent fever - Fever with abrupt onset and remission, such as in malaria. Temperature spikes occur at regular intervals.
c) Remittent fever - Fever that decreases but does not return to normal. The temperature remains elevated between peaks, such as in typhoid fever.
This document discusses fever of unknown origin (FUO). It categorizes FUO into classical, nosocomial, neutropenic, and HIV-associated types. The most common etiologies of FUO are infections (30-60%), collagen vascular diseases (20-35%), and malignancies (10-20%). The diagnostic approach involves a careful history, physical exam, and diagnostic testing including blood tests, imaging, and biopsy. Empirical therapeutic drug trials may be used for suspected conditions like tuberculosis or culture-negative endocarditis, but have limitations and risks. The goal is to reach a specific diagnosis to guide appropriate treatment.
1663503021.ppt ram jiban Yadav heath b dsaRAMJIBANYADAV2
1. The aims of the lecture are to define pyrexia of unknown origin (PUO), discuss the causes of fever, and approach to diagnosing PUO.
2. Common causes of PUO include infections (30% of cases), malignancies (20%), and connective tissue disorders (15%). Infections may be specific to locations, organisms, or patient groups.
3. Diagnosing PUO involves taking a thorough history, physical exam, and running microbiological, imaging, and immunological tests to identify potential infectious, inflammatory, or malignant causes. A multidisciplinary approach is often needed.
Hypocalcemia can be caused by a variety of factors that result in decreased calcium levels in the blood. The most common causes are hypoparathyroidism, vitamin D deficiency, and magnesium depletion. Clinically, hypocalcemia presents with paraesthesia around the mouth and extremities, muscle cramps, carpopedal spasms, tetany, seizures, and cardiac abnormalities like prolonged QT interval on ECG. Treatment involves calcium supplementation, often with vitamin D, to replace the deficient levels and address the underlying cause.
According to a study in Nepal, the most common causes of pancytopenia (low levels of all blood cell types) are hypoplastic bone marrow, hematological malignancies like leukemia, and megaloblastic anemia. The document then describes a 45-year-old man who noticed red-colored urine on two occasions and sought medical attention due to concern over the recurring symptom.
Hypocalcemia can be caused by several factors like vitamin D deficiency, malabsorption, renal losses, drugs like platinum agents, and conditions affecting the parathyroid glands. Clinical manifestations include paraesthesia, muscle cramps, seizures, and cardiac arrhythmias due to increased neuromuscular irritability when calcium levels drop. Diagnosis involves measuring serum and ionized calcium levels along with phosphate and parathyroid hormone levels. Treatment focuses on replacing calcium supplementation and treating the underlying cause.
This document defines fever of unknown origin (FUO) as a fever over 38.3°C on at least two occasions lasting over 3 weeks where the cause remains uncertain after examinations. It also defines inflammation of unknown origin (IUO) as similar but without fever. The most common causes of FUO are listed as infections (40%), neoplasms (20%), non-infectious inflammatory diseases (20%), miscellaneous causes (10%), and undiagnosed (10%). In non-Western countries, infections like tuberculosis account for 50% of cases, while in Western countries non-infectious inflammatory diseases are more common.
DR.RAM%20PPT.pptxcivil service Nepal kathMRAMJIBANYADAV2
A 45-year-old bank clerk experienced red urine on two occasions and sought medical attention. Tests were ordered to investigate the cause, including complete blood count, renal and liver function tests, electrolytes, LDH, calcium, uric acid, coagulation tests, and blood typing. Pancytopenia is a decrease in levels of all three major types of blood cells - red blood cells, white blood cells, and platelets. It can be caused by autoimmune destruction of blood stem cells in 40-50% of cases, as well as hepatitis, CMV, HHV, and other infections.
DENGUE FEVER BY DR.RADHE.pptx CIVIL HOSPITAL NEPALRAMJIBANYADAV2
Dengue fever is a mosquito-borne viral illness that has spread rapidly worldwide. It is transmitted by Aedes mosquitoes and causes flu-like symptoms including fever, headache, muscle pain and rash. There are four distinct serotypes of the dengue virus. Most cases resolve without complications, but severe dengue can occur, characterized by plasma leakage, bleeding or organ impairment. Treatment depends on severity of symptoms and involves oral rehydration or intravenous fluids and blood transfusions in severe cases.
Scrub typhus is caused by the bacteria Orientia tsutsugamushi, which is transmitted through the bites of infected chiggers (larval trombiculid mites). It causes non-specific symptoms like fever, headache, and rash. Diagnosis is made through serologic testing, PCR, or biopsy showing lymphohistiocytic vasculitis. Treatment involves doxycycline or azithromycin for mild-moderate cases. Severe cases are treated with doxycycline. Prevention focuses on avoiding chigger bites in endemic rural areas in parts of Asia and the Pacific.
This document provides an overview of various rheumatological conditions categorized by presenting symptoms such as fever with arthritis, Raynaud's phenomenon, oral ulcers, arthritis with neurological or pulmonary involvement, and ocular manifestations. For each symptom, it lists potential conditions and their associated diseases. It also outlines parts of the physical examination, diagnostic tests including blood tests, joint aspiration and synovial fluid analysis, imaging modalities, and potential drug histories, malignancy associations, and family histories that can aid in rheumatological diagnosis.
1. Therapy with DMARDs should begin immediately once a diagnosis of rheumatoid arthritis is made, with the goal of sustained remission or low disease activity.
2. Methotrexate should be the first treatment, and if it cannot be tolerated leflunomide or sulfasalazine can be considered.
3. Short term glucocorticoids can be used to bridge treatment until DMARDs take effect, but should be tapered off rapidly. Failure to sustain treatment targets after tapering glucocorticoids requires adjusting therapy.
This document provides guidance on evaluating joint pain through a step-wise process. It outlines taking a thorough history, physical examination, and lab investigations. The key steps include determining if the pain is articular or extra-articular, identifying if it is arthralgia or arthritis, distinguishing between inflammatory and non-inflammatory arthritis, assessing duration and pattern of joint involvement, and looking for extra-articular manifestations. Further guidance is given on specific physical exam assessments, potential lab tests, when to perform joint aspiration, and appropriate imaging studies. Common rheumatological conditions are highlighted throughout the evaluation process.
This document discusses systemic lupus erythematosus (SLE), a multisystem autoimmune disease. It covers the disease manifestations, assessment of disease activity, management approaches, and monitoring of treatment response. The goals of therapy are to achieve remission, prevent organ damage, minimize drug toxicity, and improve quality of life. Disease activity is assessed through patient history, examination, and laboratory tests. Treatment involves hydroxychloroquine for all patients along with additional therapies depending on disease severity and organ involvement. Specific treatments are outlined for various SLE manifestations. Newer targeted therapies and those under investigation are also mentioned.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system